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Vitamin A supplementation in neonates

Vitamin A deficiency is a public health problem in many parts of the world, particularly Africa and South-East Asia. In infants and children, vitamin A is essential to support rapid growth and to help combat infections. Inadequate intakes of vitamin A may lead to vitamin A deficiency which can cause visual impairment in the form of night blindness and may increase the risk of illness and death from childhood infections, including measles and those causing diarrhoea.

Generally, infants are born with low vitamin A stores and are dependent on external sources, most importantly breast milk. In settings where vitamin A deficiency and/or undernutrition is common, infants are likely to receive inadequate amounts of vitamin A from breast milk due to poor maternal nutritional status.

In many countries where vitamin A deficiency is a public health problem, vitamin A supplements are provided to children 6–59 months of age to reduce the risk of illness and death and there has been considerable interest in vitamin A supplementation in the neonatal period to achieve the same outcomes. Results from studies to date – including three large trials conducted in India, Ghana and Tanzania – are inconsistent, however, with most providing no clear indication of benefit of neonatal vitamin A supplementation.

WHO recommendations

At the present time, neonatal vitamin A supplementation (that is, supplementation within the first 28 days after birth) is not recommended as a public health intervention to reduce infant morbidity and mortality.

Additional information for this recommendation can be found in the guidance summary and in the guideline, under 'WHO documents' below.